ST. LOUIS — His candidacy spiraling out of control, Donald Trump faced Hillary Clinton on the debate stage Sunday night in the most critical moment of his political career.

Questions about Trump's preparation, policy knowledge and temperament all were overshadowed by the political fallout from Friday's release of a video that captured the Republican presidential nominee making predatory sexual comments about women a decade earlier.

With tensions high, the candidates refused to shake hands at the start of the debate at Washington University in St. Louis, then tangled repeatedly for 90 minutes.

Here are the top takeaways:

TRUMP GOES AFTER BILL CLINTON

After threatening for weeks to bring up Bill Clinton's sexual scandals, Trump finally went there.

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Even before the debate began, Trump appeared alongside several women who had accused the former president of unwanted sexual advances decades earlier. It was a risky move that threatened to damage Trump's already poor standing with women. But with his campaign in virtual freefall and his party in revolt, he may have had nothing to lose.

Once on stage, Trump pointed out the four women he had invited to attend the debate — among them Paula Jones and Juanita Broaddrick, who accused Bill Clinton of sexual impropriety decades ago. He called Bill Clinton's actions "far worse" than Trump's own words on the 2005 recording, where he bragged that he could "do anything" to women because of his fame.

"There's never been anybody in the history of politics in this nation that's been so abusive to women," Trump said.

Trump also tried to link Hillary Clinton to her husband's actions. "Hillary Clinton attacked those same women and attacked them viciously," he said.

The Democratic nominee stayed focused on her message, stressing Trump's history of sexist and racist remarks.

She fired off a list of people and groups he's insulted — including his years-long questioning of President Barack Obama's country of birth. "He owes the president an apology. He owes our country an apology and he needs to take responsibility for his actions and his words," she said.

TRUMP ON THE VIDEO

Trump's team had signaled he would deliver a sincere apology, on the debate stage, for the sexually predatory language he used on the 2005 video.

He did not.

Instead he repeatedly called his comments "locker room talk." And when pressed by a moderator, he refused to acknowledge that his reference to kissing women and grabbing their genitalia without their permission represented sexual assault.

"I apologize for those words. But it is things that people say," Trump said.

He then linked his comments to his ability to take on the Islamic State group.

"I'm very embarrassed by it. I hate it. But it's locker room talk. It's one of those things. I will knock the hell out of ISIS," he said.

CLINTON ON THE VIDEO

Clinton begged to differ. She said the remarks captured on video simply reinforce Trump's comments throughout his campaign.

She noted he has attacked a former Miss Universe, the Muslim parents of a slain American soldier and a Hispanic-American judge.

"Yes, this is who Donald Trump is," she said, later adding, "This is not who we are."

CLINTON DEFLECTS ON WALL STREET

Clinton was questioned, too, about her own Friday night revelation: the publication by the WikiLeaks organization of thousands of emails the group said belong to Clinton campaign chairman John Podesta.

The emails included a document that outlined what Clinton said in dozens of highly paid speeches before launching her presidential bid. Throughout her campaign, the Democrat has refused to release transcripts of the speeches.

Clinton deflected questions about what she told Wall Street bankers, lobbyists and corporate executives in the closed-door speeches, turning the focus to the efforts of Russia to influence the election via computer hacking.

"They are not doing it to get me elected," said Clinton, stressing Trump's ties to the country and praise for Russian leader Vladimir Putin. She said Americans "deserve answers" about Russia's involvement.

The U.S. government has lodged a formal complaint against Russia for trying to influence the outcome of the election.

TRUMP DISSES HIS RUNNING MATE

In one of the more unusual moments in a night full of them, Trump said he disagreed with his own running mate on the proper strategy to deal with the civil war in Syria.

A debate moderator pointed out that Trump's vice presidential nominee, Indiana Gov. Mike Pence, had said provocations by Russia in Syria need to be met with "American strength" and the U.S. should be prepared to use air strikes against President Bashar Assad's government.

"He and I haven't spoken and I disagree," Trump said of Pence.

Pence and Trump's relationship is already strained due to Trump's comments in the 2005 video.

TRUMP TAKES ON MODERATORS

It took just 25 minutes for Trump to begin attacking the debate moderators, Anderson Cooper of CNN and Martha Raddatz of ABC.

The approach is in line with a popular attack line during his rallies, where he often calls the media "disgusting" and dishonest.

"It's nice to have one on three," Trump charged. He later added: "Why do you interrupt me all the time? Why don't you interrupt her?"

The moderators offered sharp words for Trump at times, as he repeatedly interrupted Clinton.

"Please allow her to respond, she didn't interrupt you," Cooper said.

TOUGH TONE UNTIL THE VERY END

The debate started with a contentious tone, with the candidates forgoing the traditional handshake in favor of simply standing side-by-side.

Trump repeatedly interrupted Clinton, referring to her as "the devil" and saying she has "tremendous hate in her heart."

The Republican also said a Trump administration would appoint a special prosecutor to investigate Clinton's use of a private server as Secretary of State.

"It's just awfully good that someone with the temperament of Donald Trump is not in charge of the law in our country," Clinton replied. Trump fired back: "Because you'd be in jail."

Elected leaders in Western democracies don't often threaten political opponents with jail.

It wasn't until the final question that they offered somewhat kind words for each other — and then only because an audience member asked what they respected about their opponents.

Clinton offered praise for Trump's grown children. "I don't agree with nearly anything else he says or does, but I do respect that," she said.

Trump described his opponent as a fighter: "She doesn't quit. She doesn't give up. I respect that."